How Payers and HIT Analytics Can Help Primary Care Physicians Improve Care Quality

 In Healthcare Transformation, Productivity & Management

Primary care physicians (PCPs) are in the best position to coordinate patient care, because they understand their patients’ unique needs. But knowing which specialists can deliver the most effective care when a referral is required can challenge even the most experienced PCP.

That’s because PCPs rarely have insight into the costs and quality of care delivered by other providers. Lacking this evidence, they have no alternative but to base referrals on personal experience, professional recommendations, doctor ratings, and patient requests.

This is changing, however, thanks to a new approach called “episode intelligence.” Using HIT analytics, episodes of care are analyzed to identify physicians and facilities that can deliver the most effective care throughout a course of treatment.

One innovative organization using episode intelligence is Tandigm Health, a value-based healthcare company supporting primary care physicians. Heading Tandigm’s effort is Director of Informatics Tony Tedesco, an early adopter of the technology. Tedesco is using it to help PCPs improve patient referrals, measurably helping them deliver higher quality care at a lower cost.

In this interview, Tedesco talks about:

  • How and why Tandigm is using episode intelligence to put primary care physicians back in charge of patient care
  • The primary care physician’s evolving role in coordinating comprehensive care
  • How episode intelligence improves utilization of specialists, which leads to higher-value care

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ROBERT CAPOBIANCO (“CAPPY”): Welcome to Episode Intelligence, a podcast dedicated to finding the value in value-based care. I’m Robert Capobianco, Cappy for short, and I head up the value-based care analytics team at Change Healthcare. Today I’m speaking with a good friend of mine, Tony Tedesco. He is the director of informatics at Tandigm Healthcare. In our discussion, we’re going to learn more about Tony’s background. We’re going to get a better understanding on how his informatics experience is helping Tandigm advance their value-based care strategies. We’ll conclude today’s discussion learning more about how Tandigm is using value-based care strategies to achieve their specific goals. Tony and I have known each other for probably ten years. So thanks again for coming onto the show, Tony, and helping us out here and giving us your perspective on how to find the value inside value-based healthcare. I’d like to jump just kind of right in Tony, and tell me just a little bit about yourself. How did you get to this stage in your career? Why’d you choose healthcare? Kind of start there.

TONY TEDESCO: Great. Thanks, Cappy, for having me. I’m looking forward to this podcast. I was an IT consultant for 15 years or so with a company called CSC. As my family started to grow, I wanted to get away from the consulting lifestyle. I also wanted to do something more entrepreneurial. Ended up working at Accolade, an early-stage company in the Plymouth meeting area where we met. And that was really eye-opening for me. That’s how I realized that our healthcare system was broken. Learned about population health. And I didn’t really choose healthcare, it chose me. I got to see that this is a big problem in our country. I want to be part of the solution to improve healthcare. Keep Americans healthier. At Tandigm I have the opportunity to do that with the folks in my community. I’m born and raised in Philadelphia. So we get to do that in the Philadelphia area.

CAPPY: It’s a good segue. Can you tell us just a little bit about the mission of Tandigm? How did it come about? You guys have had some recent news in the community. You’re doing well. But maybe let’s start off with you know, take a 20,000-foot overview of Tandigm and tell the audience what you guys do there.

TONY: Sure. Tandigm was formed in 2014 with the mission to put the primary care physician back in charge of healthcare. We want them to be the quarterback of healthcare, and be the stewards of healthcare for their patients. We’ve completed our third operational year and reached a profitable milestone which is great for an early stage company. We engage, enable, and empower our primary care physicians. We provide both clinical resources, and my role is to provide the informatics and analytics, and the reporting and the insights and the data that’s actionable for them, so that they can get access to information that they’ve never seen before.

CAPPY: Great. So it’s taken that data, empowering the physician relationship, helping them. What kind of decisions are you helping them with? What is the data, is the talk of the town? It’s the new currency inside of healthcare, specifically within episodes. Can we talk a little bit about the data that you’re bringing into the physician relationship? How that’s sort of helping them?

TONY: It’s really understanding what happens to their patients when they’re not in the office. There’s something as simple as this patient that you have that might be going to the ER repeatedly when (it’s) something that you can be treating, or when the physician needs to refer the patient to a cardiologist or an orthopedic surgeon, to understand what their choices are.

CAPPY: So tell me a little bit about the kinds of care you’re targeting. Because PCP’s do lots of things. I think they carry one of the biggest burdens inside of the healthcare arena. When the people come to them, they’ll see them, then they go out to the specialist, they come back to them, they didn’t necessarily perform the care. Huge role inside of the healthcare community. Many will argue that because of the lack of PCP’s and the growth in specialties healthcare got even a little bit more disconnected. So what kinds of care are the PCP’s targeting? What’s working for them? What’s the challenge with those kinds of models?

TONY: That’s a great question. We want to put the PCP back in charge. So they’ve, as you said, they sometimes get bypassed and their patients may go right to specialists and the care may not be coordinated. So we want to help the primary care physician coordinate the care across the continuum that that person needs. In our case, where there’s a higher acuity patient that needs our support, we also provide, Tandigm provides, that clinical support of nurse navigators to help telephonically. We also have in-person programs where, for the higher acuity patients, we have nurses, or nurse practitioners that’ll go into the home or someone’s at a skilled nursing facility, make sure that nobody’s falling through the cracks, and get folks home safely and healthy and try to keep them healthy and at home where most people want to be.

CAPPY: So it’s really an extension model. It’s not only just sort of a data information model, making the data around some of those choices transparent to you but you’re helping with some of the struggles out there or the challenges. The PCP only has so much time. And they don’t travel with the patient in between their pieces of care. So you guys actually extend with the care coordination model, even going into the patient’s home?

TONY: That’s exactly right. Beyond just coordinating care, we actually treat our patients. And in some cases, with someone (who) is homebound and they can’t get to the PCP, we go to the PCP. We have preferred skilled nursing facilities in the Philadelphia area where we have doctors that round on our patients daily so that they don’t fall between the cracks.

CAPPY: And I know that (from) the recent press release. I think since we’re really trying to focus on, how do you find the value in value-based care? You guys just did a tremendous press release on some of the savings. So I think when people hear about these models the concept not necessarily is new. I think the success is new. Because we’ve been trying to do this for a while. Can you talk to just some of the numbers you’re seeing in Tandigm around just improvement in visits and different assessments that you guys are doing?

TONY: Yeah. We’ve had a great year and it’s been exciting to be part of Tandigm almost from the beginning. If you compare 2017 versus 2016 we’ve had 94% of our Medicare Advantage patients in for a comprehensive visit. So they’re being seen by the PCP’s and being treated. And we’ve also reduced the inpatient hospitalization of that population by 7%. We’re also having similar impact on our commercial; Tandigm Health supports both Medicare Advantage people and the commercially insured folks.

CAPPY: Okay. Not impressive numbers though to be able to make an impact. A lot of the times, I say and maybe this is true for you. I’m not necessarily a physician. But the only way I can impact one of the problems that affects us at home is to do jobs like this where you create technology and solutions that kind of creates the barrier. I’m never going to go out and get my PhD and be a PCP and pieces like that. But this is the little bit that we can contribute and to see what you’re doing again, the local impact. To be able to reduce 7% of the readmits and really coordinate the care for probably people we know. So pretty cool way to be involved. If we can kind of take a step deeper now, I was going to kind of get into some of the things that we share between each other just around analytics, and episode analytics to be specific. So sounds like you’ve found an innovative way to use lots of different technology. But let’s talk about the use of episode analytics to achieve Tandigm’s goal. How did you come to the thought around sort of episode intelligence? Being able to kind of take a wrapper? Because I would say that you represent one of the more innovative ways, newer ways to take episode intelligence and not necessarily do what a lot of people do, which is bundles or kind of move it into an ACO program. You use it more directionally in terms of how do you steer and I guess provide intelligence back to that provider to let them do the choice. Can you talk to a little bit about how’d you come to the thought around using episodes beyond bundles? How is it helping you solve some legacy challenges that you might not have been able to address maybe five or ten years ago?

TONY: Well I have you to thank really. We met at Accolade and you moved on and joined HealthQX and we had coffee and we spoke about what you were doing at HealthQX and I thought to myself, wow that’s something that I think we could use. And I had just recently joined Tandigm and it wasn’t an immediate priority at the time. And as time went on, and if you’re trying to look at medical claims and figure out an episode of care, it’s impossible to do that yourself in our case. And since you, since HealthQX had already figured that out it didn’t make any sense for us to try to reinvent the wheel. The nice thing about the HCI3 model is that it’s an industry-accepted standard definition of episodes of care. And it gives you more than just the cost of the colonoscopy or the knee replacement or the hip replacement because it’s looking at the entire episode, you really get a good idea of what the practices of specialists are. And in Philadelphia, there’s lots of choices. So how we decided to use the data was to focus on certain specialties and analyze the results of those providers and the cost and value that they provide for different procedures or episodes of care within each specialty. So, for example, in orthopedics we look at the, we would look at hips and knees and knee arthroscopies and different procedures and acute conditions, chronic conditions that roll up under each specialty and that gave us an idea of the different options that our PCP’s have in terms of referring their patients and our members. So we chose the HealthQX model because it provided that kind of unbiased definition of the episode and it did the heavy lifting of analyzing the historical claims data to give us that insight. It would be impossible to try to do that ourselves.

CAPPY: It’s interesting. So you just sort of use it as an initial identification of the context, the disease context that you’re interested in. And then you move that into sort of looking over the spectrum, sort of the continuum of care because you’re getting that sort of where does an episode begin and where does an episode end. And that helps you take that choice and move that into more sort of a okay they see you initially but you’re probably referring them. So you’re informing that referral choice. Is that saying too much? Or is that I just want to make sure that the listeners are sort of understanding how do you consume that and then move that into the relationship with the PCP.

TONY: It’s really healthcare is unique in that you could “buy something” but not know what it’s going to cost. And the person that’s suggesting that you buy this doesn’t know either. And in fact, if you went to most providers and asked them how much is it going to cost me to get this diagnostic or this test or this procedure, it’s hard for anyone to really answer that. We can figure it out within 90 days usually after the fact. But it’s really hard to understand the cost of one specific thing let alone an entire episode of care. So we really were able to use this information that’s provided to give our primary care physicians an understanding of what it means when you refer someone to the different providers in the area.

CAPPY: And I think from that standpoint, and I’m wondering if you agree or not is at that point when you’re in the point of utilization or in the point of providing the care it’s not necessarily what we want the doctor thinking about anyway. We want them thinking about their patients. How they’re trying to treat them. So it’s, I think it is a context that many people don’t understand. We’ve lowered the amount of time a physician at any level is allowed to spend with a patient. It becomes very transactional. And in that transactional movement they lose context because they start to go through it. So I think you bring up an important point around doctors are out there to do great care. No one got into the business to perform poorly or do the wrong thing. But that observation or the service that you provide actually brings a context back to them. Which is an interesting use of analytics. It’s not necessarily what someone would have created an episode for maybe ten years ago even though there were less of them then. Let’s jump into the provider relationship a little bit because I think you have a unique provider relationship by the Tandigm model. We know that provider markets still sort of struggle to embrace value-based care at certain levels. How is Tandigm building a provider collaboration that makes the needs of the VBP programs successful? That’s really about, in my mind, what’s worth sharing with them? What do they respond to? How do they push back on that information? I’m sure they do, which is good as part of the collaboration. Can you talk to that a little bit? How do you make this be successful? I think Tony, over time what we’ve seen that works in healthcare is when there’s a benefit going back to the payer. The provider recognizes that however they’re making a clinical transformation, there’s value back to the practice. And there’s usually a flow down through to the consumer as well. Can you speak to kind of how do you collaborate around with a physician to help them win?

TONY: Sure. So with the power of the HealthQX technology, we were able to identify the costs of all of the different options in the Philadelphia market. And we use that to come up with a list of recommendations for our primary care physicians. And we reach out to those specialists and work with them to come up with some guidelines and how we want to work together because care coordination is important and sharing information is important and we all have different systems and different EMR’s and sometimes it’s a challenge to do that. So we asked for their commitment to work with us and our primary care physicians to help us coordinate care and help us treat our patients more effectively. And they agreed to do that. And so we’ve come up with.

CAPPY: Is it an easy process, though?

TONY: Nothing’s easy in healthcare.

CAPPY: But especially in the beginning. What’s that like in the beginning? Because I think a lot of, you talk about it very casually but a lot of folks that I interact with on a range of different programs, that’s an initial struggle, is the first approach into the provider relationship. How did you kind of tackle that first? I’m sure they weren’t waiting there just kind of, “Come on Tandigm, come into my practice.” How’d you get through that barrier?

TONY: It was a big strategic initiative for Tandigm. We wanted to focus on specialist utilization, and we think there’s an opportunity to provide higher value care. And so we focused on it and it was a multi-year effort. Prior to HealthQX we had some initial initiatives that we had worked on, on ourselves, and it, you just kind of chip away at it. You build relationships and you work with the network both on the primary care side and the specialist side continuing to kind of foster dialogue.

CAPPY: Okay. So it’s a multi-year effort really up at the front. So you invested heavy in really having a conversation with them, probably repeats coming through.

TONY: That’s exactly right. We’re not the payer. We are negotiating on the payment contracts and so we have to rely on their cooperation and their willingness to help us.

CAPPY: Okay. And I would see sort of in that role of forming that relationship I guess the Tandigm folks come to you in those conversations and they’re using data as a way of sort of helping build that trust? Is that saying too much? Is that an overcommitment from the data? What’s I’m sort of trying to dig in to, how do you just kind of submit yourself within? Now success definitely helps when you’re able to go back and show them that they’re improving. But can you point to any one thing that is sort of the icebreaker in that relationship? Or is it just constantly sort of chipping away and developing a new relationship with them?

TONY: There’s a sentinel effect as you start to measure things that people tend to improve. It’s hard to lose weight if you never step on a scale. A lot of this information is not readily available, so as you start to share information it opens the eyes of many of the different people involved. Then they try to do better. Because everybody at the end of the day like you said, everybody’s out for the better, higher-quality care for their patients.

CAPPY: What surprised you in the process?

TONY: What process?

CAPPY: Just developing these relationships with the physicians. Whether it’s been harder than you thought. I’m sure you stepped into Tandigm with some initial impressions. We all did from having a background in some parts of healthcare just experiencing healthcare ourselves. Has there been parts about the adoption of your program that has surprised you? The barriers? Maybe there’s some barriers you didn’t think about that surprised you? But on that level, has there been challenges or successes that just kind of you went oh, I didn’t think that was going to happen?

TONY: Yeah. That’s a good question. If you’ve never worked in healthcare you don’t really appreciate how the challenges with healthcare data. It’s not the transaction like you buy a widget on an e-commerce site and there’s a payment and a Sku. With healthcare there’s adjudication processes and reversals and rejectivity and it’s really hard to get your hands around the data. So the challenge is around that. And then to try to extend that to say, what should all be included in that episode. You know just the idea of trying to define an episode is challenging. We’ve seen the change from ICD-9 to ICD-10. Just managing the data has been kind of the biggest challenges for the Tandigm informatics team that I have the pleasure of leading. In terms of change beyond our walls, nobody really wants to change. If you ask people, do you think we need to change? They all say yeah. We need change. And then you say okay, let’s change. And they say well, I don’t want to change. It’s a process. But it’s got to be a win/win.

CAPPY: Describe the win/win for you guys and how you, and the win for the provider. Is this helping them achieve a higher quality level rating which helps out their reimbursement structure? What’s some of the, for the details you can go into. I’m not asking you to give away your model. But what is the value that materializes for the provider? And how does that help them out from a business perspective? Because I think improving care is always an objective. And again, I don’t think any provider goes out there to provide bad care. I just don’t. But they’re also running a business. I think that part gets forgotten in sort of the healthcare story. There’s a business underneath healthcare. Can you speak to how that reward materializes for them as they work with Tandigm? Is there an improvement in their quality score? Is there an improvement in their reimbursement? Do you help them build out patient volume and pieces like that, making sure that they’re part of the network? How does it work?

TONY: In terms of the primary care physician specialist relationship, as we work with that group of specialists there’s better relationships built between the PCP and the specialist, and the more apt to work together. Because we’ve figured out that these providers provide the high-value care, it’s less costly for Tandigm and also to the extent that the patient has more cost that the, more skin in this game so to speak. It’s savings for them as well.

CAPPY: Great. So the kind of operating within the budget. They’re sort of hitting their performance markets and having a better conversation there. It’s an interesting point. So I hear this a lot in sort of PCP models, patient-centered medical home models where the PCP is the quarterback. They will object to the care that they don’t provide, especially when it comes to the specialist. A PCP especially in a sort of a more PPO-based plan where the consumer can make any choice they want no matter what the recommendation is. But I hear this a lot from the PCP community around how are you holding me accountable for care that I don’t actually provide? Once they leave my four walls and move on to that, do you see that in your conversations with the PCP’s? And how do you sort of get through that? It’s an interesting thought to have from a PCP’s perspective when we talk about continuum of care and you’re in charge. But an argument will come. And I think there’s justification in this argument around yeah, but I don’t necessarily control that piece of care. I’ve recommended something. What are your PCP’s saying to you? I’m sure you’ve heard that before.

TONY: Yeah. And I think that’s part of the reason why we wanted to create a group of specialists that we can trust and rely on, so the PCP may make the right recommendation. But because it’s a group that has been curated by Tandigm we know that they will provide high-value care even if you don’t have an HMO and you need a referral. In my case, I would ask my PCP regardless because I don’t know if I needed a procedure where to go. There’s lots of choices. But I trust my PCP and I have a good relationship with the PCP. So it’s really about the PCP understanding the needs of his or her patients and helping that person make the right decision for that individual.

CAPPY: It’s neat because you’re addressing a piece of the problem I didn’t actually understand from your business, around the sort of that curation of the specialist’s relationship. You have that with the PCP already. It’s an interesting dialogue which is supported by data around how to make that choice. So I think it’s an important part for the audience to understand. Your focal point is the quarterback, but you’re using sort of intelligence to not only help them with pathways, referral pathways and selection and choice but in through that process of the sort of a secondary benefit is that trust-bound relationship that you now get in the selection of your specialist. It’s kind of neat. I don’t think, it wouldn’t have dawned on me until we kind of got into the dialogue about that happening. You’ve been in tech for a long time, so I’d be remiss to not, for the technical audience out there that are thinking about how do they get into this journey absent of the analytics and pieces like that, can you talk to me just a little bit, a couple seconds around the technical choices you’ve had to make around cloud, or is there security things that you would bring up or enterprise data warehouses versus something else. What would you make recommendations, not by name or purpose, but what helps you especially with your background? I think that’s a valuable piece there. What’s the infrastructure look like? What would you have chosen, hindsight’s twenty-twenty, back then knowing what you know now? What’s different in that IT buy? Or what do you need to be prepared from an infrastructure sort of technical architecture perspective?

TONY: Well, because you want to provide your doctors with actual information that often leads to patient-level information. And obviously we live in a world governed by HIPAA. And with all the privacy breaches and concerns that have happened across different industries, you really want to be sensitive and protective of people’s data. So that’s an important security and compliance consideration that you have as you start to share patient-level information. Both how to present it and making sure it’s treated with the care and respect that it needs. And because we have such a big network and our primary care physicians are independent, we need to make sure that we have the correct firewalls and the data is siloed off.

CAPPY: You know, everything talks about processing power today. Are you in agreement with more processing power? Are you interested, separate the hype from fiction or fiction from truth, sort of statement. Are you finding a need to go to the cloud to do more nodal type of processing? Are you excited by that? Give me your insight there a little bit around some of this processing power. When you’re trying to talk about, and I bring that up, Tony, only because when you talk about claims-line level of information down to the discrete activity that happened inside an episode, it’s not just reading the fundamental aggregated claim. You’ve got to get down into the nitty-gritty. So, and you’re doing it for lots and lots of people which turns into millions and millions of rows of claims. So what do you think about the talk track around speed and cloud-based processing and all that?

TONY: Speed is very important because were our PCP’s to either interrupt their workflow or do additional work in their workflow, so if we create a report that provides this great, insightful information and it takes 15 seconds or 30 seconds to load, it’s not fair to ask them to slow down given all the work that they have to do. So performance is paramount when it comes to developing reports or anything that you want the PCP to use in real time in the workflow. I’m excited by artificial intelligence, machine learning, even blockchain, but there’s not any immediate need for us right now. Just excited about where that’s going to take healthcare and how all that technology will enable us to continue to work on this problem.

CAPPY: Sure. I think that you get that historical data intelligence. That the ability to do machine learning over the top of that. And maybe get to a level of prediction versus sort of looking at it in retrospect and then informing the future opinion. It’s kind of neat. It’s a neat application of technology. I agree with you. I think we’re still at the sort of the exploratory stage around ML and AI. It’s an interesting … but where would you, if you sort of had the crystal ball, where would you apply a machine learning or an AI if time wasn’t an objective or objection and money and all that other things. We get focused on what we need to be able to do. But if you were to apply some of that, where would you start? What might you start to tackle with machine learning and artificial intelligence?

TONY: For us, because we have limited resources and we need to make sure that we’re knocking on the right doors and calling the right people. I think continuing to refine our processes around risk stratification and identifying people that are appropriate for certain clinical programs. Identifying folks that are at rising risk for a certain disease. I think there’s algorithms and technology out there that do that now. I think that can only get better. And so that’ll be interesting to see how that unfolds over the coming years. As far as portability of data, lots of big players in technology have tried to solve that. I think that’s a growing problem. I don’t think we’ll have a single payer any time soon so there’s always going to be the need to see my personal medical record. If blockchain can play a part in that or there’s a way where we can really have that MRI in my pocket so I don’t need to get it done again because I’m on vacation and seeing an ER doc that doesn’t know me or doesn’t have access to my information. I think that would be powerful as well.

CAPPY: Okay. Interesting. There’s lots of talk on blockchain. We can connect you with super nerds here and we could talk about all the blockchain pieces. Definitely an exciting advancement. There’s another piece that I think I wanted to talk to you about in terms of that tech stack, and then we’ll kind of move into sort of the concluding the interview. But the emergence of analytics being provided by more self-service. So you know how we do our thing. We basically give you data and we give you an interface and you sort of interact with that. Or you can stem reports off of the data delivered and it gets delivered to Tandigm. Now there’s this whole emerging notion that you bring data essentially into a cloud. You meet in the middle in the cloud and then you can bring your own sort of. if you’re a SAS person or if you’re a TABLO person or you use Jaspersoft or many of the other number of visualizers out there. What do you think about that? Is the market ready to kind of come and meet in the cloud, in the middle and basically develop their own reports from data lakes or data ponds or whatever you want to call your next data big piece? What do you think about that?

TONY: I don’t think the market has a choice because the consumers are ready. They want more information. They want reports. They want data. And then I don’t necessarily mean each and every patient that is a Tandigm patient, but I mean our internal users that we support. So the folks that interact with our primary care physicians and the care team. They are hungry for information and they want more and more and they want it displayed in visually appealing graphics and they want the ability to drill down and they want to see month-to-month trends. But they also want to pick a point where they can drill down and get to a person or a data service. So we need to do the best we can with the tools available to meet that demand.

CAPPY: Right. Because there’s only so much of you and your group. Personally I’ve experienced how hard it is to find qualified statisticians, data scientists, the numbers of people that come along and you guys aren’t cheap. So it’s always hard to purchase as many as you’d like. But it’s an interesting piece for the audience to understand especially when they’re inside of episodes. And I want to take a point there. So analytics is not devoid of analytic support. They need people like you to be able to interpret data even when you deliver data. But a level of self-sufficiency in the user you’re also currently serving. I’m not saying that you’re going to completely go away and machines kind of do their pieces. Machines only do the work of people so well. But I think it’s an important piece for the audience is that your provider engagement people are needing to get a layer deeper than the reports, probably than traditional. Is that true?

TONY: That’s exactly right. And we have a business analyst team that has access to data and they can generate reports and share the burden of meeting the demand of the business. It is because of the consumerization of technology you come to expect charts and data and graphs, people have fitbits and they can track their performance and their steps day-to-day and trend it and compare it to others. People expect more and more data and are willing to kind of interrogate the data in answering their own questions. So we have to make that available to them. And that allows us to build more and more.

CAPPY: So I’m knocking at the door of my episode intelligence folks that go out and meet with the providers. I think Tony’s given you an excellent piece of strategic information. There’s only so much the reports are going to be able to achieve. There’s only so much informatics support that someone like Tony in your organization’s going to be able to support. So I would take Tony’s recommendation to heart. And I’ve seen this in other operations across payers that we serve here at Change Healthcare, is that there’s going to be a sort of a leveling of your game up in terms of being able to speak to this information beyond what your informatics people are able to supply. You’re going to go out there into the wild, to the healthcare wild and talk about these numbers in front of your physicians. You may or may not be able to phone a friend back at your organization, so you have to be prepared as a provider engagement specialist or somebody that’s going to interact with the physicians today. And if you’re interacting through the medium of data, you need to be able to consume and speak and talk to that data in a fairly articulate way. Am I going overboard? But I think it’s an important part of your strategic advice here to people that are interested in episodes. Am I going too far or do you think that’s absolutely necessary?

TONY: You’re spot on, Cappy.

CAPPY: Great. Thanks. So Tony, we’ve talked about a lot. I want to just kind of, sort of, start to kind of wind down a little bit. But Tony, I know I learned some new stuff today. We talked about that quite a bit. And I’m hoping our listeners did too. I’m sure they did. Any final words of wisdom around the use of analytics? Support of your practitioners? Relationships? Because that’s really where the success is. Your approach to technology. And kind of take that from somebody that’s starting out the journey. What would you tell them versus somebody that’s looking and probably have found a level of maturity like Tandigm has. And what would you say to them kind of going forward? How do you take that next level? So if you could start with sort of the person eyes-wide-open kind of going in and wanting to achieve this. What would you say to them looking back now three years plus another ten years in health tech. What would you say to them right now around that?

TONY: Growing up there was an expression; think globally, act locally, around environmentalism. And if you think about population health you need to think population health but you need to treat each person individually. That’s the most eye-opening thing for me. Each person’s different. And healthcare is different for each person. So what makes sense for one person may not make sense for another person. But population health is great in providing kind of guidelines and a goalpost but you need to treat each person individually and to their specific needs.

CAPPY: So having that ability to sort of have your macro goals.

TONY: Right. And that’s not you or I, it’s the we empower the primary care physician to make that decision or the specialist that we recommend. We can provide the insight and the information but it’s really that doctor that needs to provide that level of discretion and understanding.

CAPPY: And of one at the end of the day.

TONY: Exactly.

CAPPY: Okay. So once you’ve mastered that skill, being able to take your macro goals but then to really apply it to the person and what they’re experiencing that day so that they can make an impact. Fast forward to where you are now. Tell me a little bit about what’s next for Tandigm.

TONY: That’s a great question and I’m looking forward to the day where we can make additional press releases and the world can know about what’s next. This is not a problem that we’re going to solve in a year, in three years, but it’s an important problem that we need to address. And I love the model that we have and I’m looking forward to our continued growth.

CAPPY: Tony, you’re an incredible resource for the community, both from a Philadelphia perspective but also just nationally. We are in the middle of one of the hottest national topics which is how do we move away from this sort of turnstile fee-for-service sort of environment to a value-based environment. For the listeners out there that are looking for recommendation, looking to connect with you, looking to learn more about Tandigm, I’m sure there might be physicians on the phone today saying hey, I’d like to maybe participate or do this. How can they reach you? Where can they read more? It’s time for the shameless plug. Let’s go into how do they find more about Tandigm? How do they reach out to you if you’re comfortable with providing that kind of information?

TONY: Sure. Happy to talk to anyone that’s interested. is our website. For anybody that wants to contact me personally you can find me on LinkedIn under Antonio Tedesco. Feel free to reach out via LinkedIn. I’m happy to connect with you.

CAPPY: Great. And Tony, just want to take a step back and do a little bit of wrap up. I want to thank you Tony for joining us today. I thought you shared just great insights with us. And that’s really what this is about, is to bring a very conversational level of what’s happening really out there in the market and talk to people like you that are actually doing it. So I want to congratulate you. There’s lots of people that talk. There’s those that do. And you guys are part of that “doing” organization. And we need more like you. Innovative thinkers. People that are willing to take the risk. And people that understand that when we help our providers win, we all win. So again, thanks a lot for coming in. Hopefully you’ll come back as Tandigm continues to have more success and tell us about the next level of story for Tandigm because I’m sure there’s a next one coming out here in the next 12, 15 months as the organization continues to go out and to fill its mission here in Philadelphia. And I imagine there’s probably aspiration to go farther. So anything you want to wrap up with?

TONY: Thank you for having me. I really enjoyed this and look forward to the opportunity to come back.

CAPPY: Great. Thanks Tony. Thanks everyone and that’s a wrap of this edition of Episode Intelligence, the podcast dedicated to finding the value in value-based care.

Change Healthcare announced CarePort Health has become the first provider partner to fully integrate the Change Healthcare InterQual Connect and InterQual AutoReview products into its Care Management application. Now CarePort customers will be able to receive automated medical reviews sent right to their Care ...

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